Published: 6 September 2018
Publications
Gathering Knowledge from Adverse Reaction Reports: September 2018
Prescriber Update 39(3): 46
September 2018
Adverse reaction reporting is an important component of medicine safety monitoring. Case reports can highlight significant safety issues concerning therapeutic products and their use.
The table below presents a selection of recent informative cases from the Centre for Adverse Reactions Monitoring (CARM) database.
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CARM ID: 125366 Age: 58 Gender: Male Medicine(s): Cisplatin Reaction(s): Cerebral atrophy, memory loss |
A 58-year-old man was treated with cyclical neoadjuvant cisplatin and doxorubicin for osteosarcoma of the femur. He subsequently experienced memory decline. |
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The DBL Cisplatin (www.medsafe.govt.nz/profs/Datasheet/d/DBLCisplatininj.pdf) and Cisplatin Ebewe (www.medsafe.govt.nz/profs/Datasheet/c/CisplatinEbeweinj.pdf) data sheets contain information on neurotoxicity, and state that neurological examinations should be performed regularly. |
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CARM ID: 127529 Age: 55 Gender: Female Medicine(s): Zoledronic acid Reaction(s): Uveitis |
Three days after infusion of zoledronic acid, a 55-year-old woman developed uveitis, with sore eyes, photosensitivity, vision disturbance, eye redness and lacrimation. |
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The Aclasta data sheet (www.medsafe.govt.nz/profs/Datasheet/a/Aclastainf.pdf) lists uveitis as an uncommon or rare adverse reaction, according to data from individual and clinical studies. |
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CARM ID: 128440 Age: 71 Gender: Female Medicine(s): Mirtazapine Reaction(s): Anger, aggression |
A 71-year-old woman with bipolar disorder and benzodiazepine dependency was admitted to hospital for re-initiation of lithium therapy. She was also switched from dothiepin to mirtazapine for treatment of depression, after which she developed physically aggressive behaviour. |
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The Apo-Mirtazapine data sheet (www.medsafe.govt.nz/profs/Datasheet/a/ApoMirtazapinetab.pdf) lists aggression as a rare adverse reaction. |
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CARM ID: 128445 Age: 28 Gender: Female Medicine(s): Erythromycin, methadone, quetiapine, paroxetine, zopiclone Reaction(s): Drug interaction, cyanosis, depressed level of consciousness |
A 28-year-old woman being treated with methadone, paroxetine, quetiapine and zopiclone was started on erythromycin for strep throat. The next day she was found unresponsive and cyanosed. |
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The E-Mycin data sheet (www.medsafe.govt.nz/profs/Datasheet/e/E-Mycintabsus.pdf) states that serum levels of medicines metabolised by the cytochrome P450 system may be elevated when erythromycin is used concurrently. Also refer to the ‘Medicines interacting with methadone’ article in the June 2018 edition of Prescriber Update. |
